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PubMedDate not supplied

[Eosinophilic fasciitis. A recently reported oligotopic connective tissue inflammation. A case report].

A 25 year old suffering from eosinophilic fasciitis is reported. This patient showed periostitis at some bones and myatrophy of thenar and hypothenar besides the typical manifestations related to the involvement of fascia and nearby tissues. On the whole these manifestations reduced the patient's mobility seriously. The typical humoral findings of eosinophilic fasciitis were present, i. e. remarkable eosinophilia, hypergammaglobulinemia with rise of Ig G, and inflammatory serum alterations. Furthermore an increase urinary hydroxyproline excretion was found which means an altered collagen metabolism. This is obviously related to collagen accumulation that in this patient was observed at fascia, perimysium and in the subcutaneous tissue. Ig G deposits were found in the fascia. The reported case raised some problems of differential diagnosis with polymyositis, progressive systemic sclerosis, localized scleroderma and, perhaps, mixed connective tissue disease.

Adult↗

PubMedDate not supplied

[Regional intravenous anesthesia (RIA): a simple method not used frequently].

We studied 20 outpatients undergoing surgery of the extremities with regional intravenous anesthesia (RIA). In our study RIA vas performed with the help of a double tourniquet in order to prevent adverse reactions; the drug of choice was lidocaine, because we considered it more suitable for this kind of procedure. The technique was of simple execution and well tolerated by the patient. This technique maker it possible to perform surgery of forearm and foot with a small amount of anesthetic even in outpatients.

Adult↗

PubMedDate not supplied

[Variability of the clinical picture and the classification of progressive systemic scleroderma].

Fiftythree patients with progressive systemic sclerosis were studied. Four of them (3 males) had the diffuse form of the disease. The skin manifestation of this clinical picture is characterized by diffuse progression of the cutaneous sclerosis over almost the whole body surface, except for the hands where it eventually may appear late. The prognosis for these patients it especially poor. Fortyfive patients (44 females) had acrosclerosis in the widest sence. Twentyseven of these ("acrosclerosis stricto sensu") had cutaneous sclerosis of the hands, face, and often other parts of the body, but not on the abdomen, arms or thighs. The remaining 18 patients had sclerotic alterations on these surfaces also. In this syndrome (which the authors call "the intermediary syndrome"), i.e. where the abdomen, arms, and thighs also are affected, certain internal organs and the joints are more involved than in "acrosclerosis stricto sensu". With rare exceptions, a symptomatic tetrade (REST-syndrome) occurred in acrosclerosis and all the intermediary syndromes. This consisted of Raynaud's syndrome (R), esophagopathy (E), cutaneous sclerosis (S), and telangectasia (T). Fifty % of the patients in addition had calcinosis (C), either subcutaneous or para-articular. The tetrade "REST syndrome" becomes in these cases the pentade "CREST syndrome". The addition of calcinosis to the other four phenomena of the REST syndrome does not alter the frequency of internal organ involvement or the prognosis of the disease. The term "REST syndrome" and its variant "CREST syndrome" should replace the conservative term "acrosclerosis" because they add to the purely cutaneous phenomena other characteristic manifestations of the disease. Two patients could neither be classified under the REST syndrome nor the progressive diffuse syndromes. Two other patients had no cutaneous phenomena ("scleroderma sine scleroderma").

Adolescent↗